Provider Demographics
NPI:1346677473
Name:RASIEWICZ, CHRISTINA M (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:RASIEWICZ
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CRAIG RD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8787
Mailing Address - Country:US
Mailing Address - Phone:732-780-2799
Mailing Address - Fax:
Practice Address - Street 1:100 CRAIG RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8787
Practice Address - Country:US
Practice Address - Phone:732-780-2799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054710001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0019895Medicaid
NJ0057151Medicaid